SUPPORT FOR YOUR PATIENTS

ALL ABOUT THE ORGOVYX SUPPORT PROGRAM In this brochure, you’ll find information to help your patients start treatment. From insurance support to ORGOVYX™ (relugolix) educational resources, we have the information your patients need.

What’s inside?

Helping Your Patients ................................................................................. 3

How to Enroll Your Patients ...................................................................... 4

Financial Assistance ............................................................................... 5-7

ORGOVYX Free Trial Program ..................................................................6

ORGOVYX Bridge Program ....................................................................... 7

Ordering ORGOVYX ...............................................................................8-10

ORGOVYX Resources ................................................................................11

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HELPING YOUR PATIENTSWe are dedicated to providing your patients support to help them start and continue taking ORGOVYX™ (relugolix) as prescribed. We know how important it is for patients to stay on track while on treatment. We’re here to help.

Here’s what the ORGOVYX Support Program has to offer:

Financial assistance

ORGOVYX Free Trial Program

We offer options to help your eligible patients afford their treatment, including copay assistance for commercially insured patients

We can help assist your patients with access challenges

Eligible patients who are new to ORGOVYX can get up to a 2-month supply of medication at no cost

Reimbursement support

Eligible commercially insured patients who are experiencing coverage issues can receive ORGOVYX at no cost for a limited period of time

ORGOVYX Bridge Program

We are here to support your enrolled patients with check-in calls to help answer their questions about treatment

Nurse support

We provide educational resources to help support your patients throughout their treatment

ORGOVYX Education

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How to enroll your patients:

For more information, call 1-833-ORGOVYX (1-833-674-6899)

Monday-Friday, 8 am-8 pm ET

CoverMyMeds is a registered trademark of CoverMyMeds LLC.ORGOVYX Support Program is not a CoverMyMeds LLC program or solution. ORGOVYX Support Program is owned and operated solely by Myovant Sciences.

HOW TO ENROLL YOUR PATIENTSEnrolling your patients in the ORGOVYX™ (relugolix) Support Program is simple.

LOG IN to your CoverMyMeds® account and submit the ORGOVYX Support Program Start Form online

PRINT & FAX the completed ORGOVYX Support Program Start Form to 1-844-826-8875. Get a form at OrgovyxHCP.com

OR

https://www.covermymeds.com/main/solutions/provider/specialty/https://www.orgovyxhcp.com/support#resources

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Based on your patient’s insurance coverage and eligibility, we offer the following financial assistance options:

For eligible commercially insured patientsWith the ORGOVYX™ (relugolix) Copay Assistance Program, eligible commercially insured patients pay as little as $10 per month.*

For eligible uninsured patientsThrough the Myovant Patient Assistance Program, eligible patients may be able to get ORGOVYX at no cost.

Learn more about the eligibility criteria by calling 1-833-ORGOVYX (1-833-674-6899).

For all patients Your patients may qualify for additional financial support resources. Learn more by calling 1-833-ORGOVYX (1-833-674-6899).

* Additional terms and conditions may apply. For full terms and conditions, visit OrgovyxHCP.com.

FINANCIAL ASSISTANCEHelping your patients pay for treatment

https://www.orgovyxhcp.com/support

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The ORGOVYX Free Trial Program is designed to help your eligible patient get started on ORGOVYX.

Patients who have not previously been prescribed ORGOVYX™ (relugolix) can get up to a 2-month supply at no cost. Patients must meet the program eligibility requirements.*

*The ORGOVYX Free Trial Program (FTP) provides an up to 2-month supply of ORGOVYX at no cost to patients who meet FTP eligibility requirements and who agree to the FTP terms and conditions by submitting a signed FTP enrollment form. (i) FTP is a free trial offer, intended solely to allow new patients to try ORGOVYX and to determine with their healthcare provider whether ORGOVYX is right for them. There is no obligation to continue use of ORGOVYX after the free trial has been completed; (ii) to be eligible, patient must: (1) reside in the United States or Puerto Rico and (2) be a new patient not currently using ORGOVYX or who previously received ORGOVYX through the FTP; (iii) ORGOVYX supplied through the FTP will be dispensed only through a pharmacy designated by Myovant Sciences up to the limits above; (iv) product may only be delivered to the patient’s home address (no P.O. boxes) or the prescribing healthcare provider’s office; (v) it is unlawful for any person to sell, purchase, trade, barter or export ORGOVYX supplied through the FTP or make an offer to do so; (vi) ORGOVYX supplied through the FTP may not be billed (in whole or part, directly or indirectly) to any patient or third-party payer, including Medicare, Medicaid and commercial insurance plans; (vii) Myovant Sciences reserves the right to change or discontinue the FTP at any time without notice; (viii) the FTP is not health insurance; (ix) the FTP is not a discount, rebate, coupon, cost-sharing program or other form of financial assistance and no portion of the value of the FTP product may count as a patient out-of-pocket expense under any health insurance program; (x) ORGOVYX supplied free of charge through the FTP is not contingent on continued use of ORGOVYX. To continue a patient on therapy, a separate prescription must be written by the healthcare provider; (xi) the FTP is void where prohibited by law and where use is prohibited by the patient’s insurance provider.

ORGOVYX FREE TRIAL PROGRAM

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ORGOVYX BRIDGE PROGRAM The ORGOVYX Bridge Program can help commercially insured patients get access to treatment by providing ORGOVYX™ (relugolix) at no cost if they are:

*The ORGOVYX Bridge Program (“Program”) provides ORGOVYX at no cost for a limited period (up to 4 months) to eligible, commercially-insured patients whose insurance coverage is delayed or who experience a temporary lapse in coverage. This Program is not valid for patients whose prescription claims are reimbursed, in whole or in part, by any state or federal government program, including, but not limited to, Medicaid, Medicare, Medigap, Department of Defense (DoD), Veterans Affairs (VA), TRICARE, Puerto Rico Government insurance, or any state patient or pharmaceutical assistance program. Prescribers must complete the Bridge prescription on the start form. By participating, patient acknowledges intent to pursue insurance coverage for ORGOVYX with their health care provider. Program requires the submission of a request for coverage within 9 months post-Program initiation in order to remain eligible. Patients will receive their maintenance drug supply each month for up to 12 months or until they receive insurance coverage approval, whichever occurs earlier. Program is not available to patients who are uninsured or where prohibited by law. Patients may be asked to reverify insurance coverage status during the course of the Program. Patient and participating prescribers agree not to seek reimbursement for all or any part of the benefit received by the patient through this Program. No purchase necessary. Program is not health insurance, nor is participation a guarantee of insurance coverage. Other limitations may apply. Myovant Sciences reserves the right to rescind, revoke, or amend the Program and discontinue support at any time without notice.

• Experiencing a lapse or delay in coverage

• Waiting for approval from their insurance provider

Eligible patients may receive ORGOVYX at no cost for a limited period of time.*

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ORDERING ORGOVYX

ORGOVYX™ (relugolix) is supplied in a bottle containing 30 tablets that are 120 mg each (NDC: 72974-120-01).

ORGOVYX is available to in-office dispensing pharmacies and hospital/academic/institutional specialty pharmacies. ORGOVYX can only be ordered through the authorized specialty distributors below.

Ordering ORGOVYX for your pharmacy

ASDasdhealthcare.comEmail: asd.customerservice@asdhealthcare.comPhone: 1-800-746-6273Fax: 1-800-547-9413Standard Ordering Hours: Monday-Thursday 8 am-7:30 pm ET, Friday 8 am-7 pm ET

Cardinal Health Specialty Distributionspecialtyonline.cardinalhealth.com (Physician Clinics)orderexpress.cardinalhealth.com (Hospitals)Email: gmb-spd-csorderentry@cardinalhealth.comPhone: 1-855-855-0708Fax: 1-877-274-9897Standard Ordering Hours: Monday-Friday 9 AM-7 PM ET

Specialty distributors for in-office pharmacies

Myovant Sciences isn’t affiliated with, nor does it recommend the use of, any of the listed pharmacies or distributors. It is at the prescriber’s discretion to select the appropriate pharmacy or distributor for their specific needs.

Bessebesse.com Email: customercare@besse.comPhone: 1-800-543-2111Fax: 1-800-543-8695Standard Ordering Hours: Monday-Thursday 8:30 am-7:30 pm ET, Friday 8:30 am-5 pm ET

http://www.asdhealthcare.commailto:asd.customerservice%40asdhealthcare.com?subject=http://specialtyonline.cardinalhealth.comhttp://orderexpress.cardinalhealth.commailto:gmb-spd-csorderentry%40cardinalhealth.com?subject=http://www.besse.commailto:customercare%40besse.com?subject=

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CuraScript SDcurascriptsd.com Email: customer.service@curascript.comPhone: 1-877-599-7748Fax: 1-800-862-6208Standard Ordering Hours: Monday-Friday 8 AM-7 PM ET

McKesson Specialty Health mscs.mckesson.com Email: MSH.CustomerCare-MSPL@McKesson.comPhone: 1-800-482-6700 (oncology); Phone: 1-855-477-9800 (multi-specialty)Standard Ordering Hours: Monday-Friday 8 am–8 pm ET

McKesson Plasma & Biologics (MPB)connect.mckesson.comEmail: MPBOrders@McKesson.comPhone: 1-877-625-2566Standard Ordering Hours: Monday-Friday 9 AM-7:30 PM ET

Specialty distributors for in-office pharmacies (cont’d)

We’re here to support your patients prescribed ORGOVYX™ (relugolix)—from help with finding financial

assistance to reimbursement and nurse support.

Call 1-833-ORGOVYX (1-833-674-6899) Monday-Friday, 8 am-8 pm ET.

Oncology Supplyoncologysupply.com Email: custserv@oncologysupply.comPhone: 1-800-633-7555Fax: 1-800-248-8205Standard Ordering Hours: Monday-Friday 9 am-8 pm ET

Myovant Sciences isn’t affiliated with, nor does it recommend the use of, any of the listed pharmacies or distributors. It is at the prescriber’s discretion to select the appropriate pharmacy or distributor for their specific needs.

http://www.curascriptsd.commailto:customer.service%40curascript.com?subject=https://mscs.mckesson.commailto:MSH.CustomerCare-MSPL%40McKesson.com?subject=https://connect.mckesson.com/mailto:MPBOrders%40McKesson.com?subject=http://www.oncologysupply.commailto:custserv%40oncologysupply.com?subject=

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Specialty pharmacies can also provide information and resources to your ORGOVYX patients, including:• Free delivery• 24-hour access to a pharmacist• ORGOVYX medication counseling• Adherence support

ORDERING ORGOVYX

We have selected 2 URAC- and ACHC-accredited mail-order specialty pharmacies to provide service nationally to your patients.

ORGOVYX™ (relugolix) prescriptions fulfilled through specialty pharmacies

US Bioservices usbioservices.com Phone: 1-877-757-0667 Fax: 1-888-899-0067 Standard Ordering Hours: Monday-Friday 8 am-8 pm ETClinicians are available to speak with patients 24 hours a day, every day.

Biologics by McKesson biologics.mckesson.comPhone: 1-800-850-4306 Fax: 1-800-823-4506 Standard Ordering Hours: Monday-Friday 8 am-8 pm ETClinicians are available to speak with patients 24 hours a day, every day.

Specialty pharmacies

Myovant Sciences isn’t affiliated with, nor does it recommend the use of, any of the listed pharmacies or distributors. It is at the prescriber’s discretion to select the appropriate pharmacy or distributor for their specific needs.

ACHC=Accreditation Commission for Health Care; URAC=Utilization Review Accreditation Commission.

http://www.usbioservices.comhttp://biologics.mckesson.com

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• ORGOVYX Support Program Start Form

• ORGOVYX Free Trial Form

• ORGOVYX Patient Brochure

• ORGOVYX Dosing Card

• Sample Letter of Medical Necessity and Checklist

• Sample Letter of Appeal and Checklist

To download and print ORGOVYX™ (relugolix) resources, visit OrgovyxHCP.com.

ORGOVYX RESOURCES

Resources to help your patients

http://www.OrgovyxHCP.com

For more information on the ORGOVYX™ (relugolix) Support Program,

call 1-833-ORGOVYX (1-833-674-6899) orvisit OrgovyxHCP.com

ORGOVYX™ and its associated logo are trademarks of Myovant Sciences GmbH.©2021 Myovant Sciences GmbH and Pfizer Inc. All rights reserved. PP-US-REL-2100037 01/21

http://www.OrgovyxHCP.com